GP groups have commissioned 15 services under PBC, including community diabetes and respiratory care, ambulance triage and hospice at home.
In the past year, one group – Westmorland Primary Care Collaborative – has delivered a 3% reduction in non-elective admissions, and a 6% reduction in new outpatient referrals.
Dr Hugh Reeve, GP chair, Westmorland Primary Care Collaborative
On progress so far…
‘This year we have a fully delegated budget of £81m, which will nearly double next year. We’ve so far established a wide range of services – two community wards, a new minor injury and clinical assessment unit, a community-based short-term intervention team and a community respiratory team. Together, these have delivered a 6% reduction in new outpatient referrals, at the same time as virtually zero growth in our prescribing budget. Our group is establishing an information system based on EMIS web that includes all GP practices, all community teams and hospital community wards, and links with the out-of-hours service.’
On how local GPs have responded to the white paper…
‘Our practices are not fazed as we embarked on this journey two years ago. Since the white paper we’ve held discussions between the six Cumbria consortia on how we will work together and risk-share together. Our major challenge is how we disentangle community provider services from the consortia, and discussions have started around this. I feel this is the major weakness of the white paper – we had been moving towards integrated commissioning and providing organisations.’
And his advice for prospective GP commissioners…
‘Spend time talking honestly together, agree your vision (be bold) and don’t allow yourselves to be forced in a direction you believe is wrong.’
Dr Hugh Reeve: working out how to risk-share with practices Dr Hugh Reeve: working out how to risk-share with practices